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General NPI Number Information
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NPI Number | 1043367030
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Entity Type | Individual
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Provider Name | SUSAN E CUSSON APRN
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 100 OLD BILLERICA RD CARLETON-WILLARD VILLAGE
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City | BEDFORD
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State | MA
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Zip | 01730-1267
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Country | US
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Telephone | 781-275-8700
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Fax | 781-276-1934
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Provider Business Mailing Address
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Address Line | 100 OLD BILLERICA RD CARLETON-WILLARD VILLAGE
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City | BEDFORD
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State | MA
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Zip | 01730-1267
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Country | US
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Telephone | 781-275-8700
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Fax | 781-276-1934
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN174128
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License Number State | MA
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